Medical: Scopes of Practice

MRC Medical (Medical Reserve Corps—Medical Volunteers)

MP (Medical Prescriber)

Active, in-state Licensure

• MD, DO (Medical Doctor)

• ARNP (Nurse Practitioner)

• CRNA (Nurse Anesthetist)

• CNM (Nurse Midwife)

• DPM (Podiatrist)

• PA (Physician Assistant)

RN (Registered Nurse)

Active, in-state Licensure

NAP (Nursing & Assistive Personnel)

• LPN (Licensed Practical Nurse)

• CNA (Certified Nursing Assistant)

• PCT (Patient Care Technician)

• MA (Medical Assistant)

Paramedic

EMT (Emergency Medical Technician)

Emergency Medical Responder/ WFR (Wilderness First Responder)

CERT (Community Emergency Response Team)

WFA (Wilderness First Aid)

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Primary Assessment of Patient  

X

X

X

X

X

X

X

X

Basic Vital Signs (LOR, Respirations, HR, Skin, Temperature, BP, O2)

X

X

X

X

X

X

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Performing Secondary Medical Triage (Within Treatment Area)  **    

X

X

X

X

X

X

X

X

Medical Evacuation Recommendation (or transfer to higher level of care)   

X

X

X

X

X

X

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Assessment and Treatment of Active Bleeding  

X

X

X

X

X

X

X

X

Application of Direct Pressure/Pressure Dressing **

X

X

X

X

X

X

X

X

Tourniquet Application   **

X

X

X

X

X

X

X

X

Application of Quick-Clot **

X

X

X

X

X

X

X

X

Assess & Treat for Shock

X

X

X

X

X

X

X

X

Higher Level of Care Criteria: massive hemorrhage, abdominal or head bleed, persistent unstable vital signs, impalement

Tourniquet Conversion to other Hemostatic Adjuncts **

X

X

IV Fluids for Severe Shock (i.e., Lactated Ringer’s Solution)  Ω   **  ∑

X

X

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

BIEMR/WFR

WFA

CERT

Perform BLS/CPR  **

X

X

X

X

X

X

X

Use an AED  **

X

X

X

X

X

X

X

X

Assess & Treat for Shock

X

X

X

X

X

X

X

X

Higher Level of Care Criteria: cardiovascular compromise, defibrillation given, continued CV monitoring, airway compromise

Administer ACLS/PALS Medications   Ω   **   ∑

X

X

X

Perform Transcutaneous Pacing  **   ∑

X

X

X

Initiate/Insert IV access  Ω   **   

X

X

X

Initiate/Insert IO Access   Ω   **   ∑

X

X

Prescribe IV Fluids    Ω     ∑

X

Administer IV Fluids (i.e., Lactated Ringer’s Solution)  Ω   **  ∑

X

X

X

Treatment of Heart Failure   Ω   **  ∑

X

X

Treatment of Hypotensive/Hypertensive Emergency   Ω   **  ∑

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Identification of Head/TBI (mechanism of Injury)   **

X

X

X

X

X

X

X

X

Assessment of Head Trauma   **

X

X

X

X

X

X

X

X

Assessment and Basic Treatment of Penetrating Eye Trauma **

X

X

X

X

X

X

Assessment and Documentation of Basic Mental Status **

X

X

X

X

X

X

X

X

Assessment of Mental Status using AVPU or GCS scale  **

X

X

X

X

X

Treatment of Head Injury (non-invasive) **

X

X

X

X

X

X

X

Documentation of Head Injury  

X

X

X

X

X

X

X

X

Higher Level of Care Criteria: any loss of consciousness, decline in patient’s mental status

Suturing/Laceration Repair    Ω     ∑

X

IV Antibiotics, Pain Therapy, Tetanus Shot  Ω     ∑

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Airway Assessment 

X

X

X

X

X

X

X

X

Airway Positioning 

X

X

X

X

X

X

X

X

Chin-Lift/Jaw-Thrust 

X

X

X

X

X

X

X

X

Recovery Position

X

X

X

X

X

X

X

X

Pocket Mask Ventilation (rescue breaths)

X

X

X

X

X

X

X

X

Bag-Valve Ventilation    **   

X

X

X

X

X

Higher Level of Care Criteria: airway compromise, need for advanced airway, need for continued monitoring

Nasopharyngeal Airway    Ω   **   ∑

X

X

X

X

Oral Airway   Ω   **   ∑

X

X

X

X

Extraglottic Airway  Ω   **   ∑

X

X

X

Epiglottic Airway  Ω   **   ∑

X

X

X

X

Airway Suctioning  Ω   **    ∑

X

X

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Assessment and Documentation of Respirations 

X

X

X

X

X

X

X

X

Treatment of Sucking Chest Wound/Chest Seal   **

X

X

X

X

X

X

Higher Level of Care Criteria: need for invasive care, airway compromise, need for oxygen therapy, need for needle decompression

Needle Thoracostomy    Ω   **   ∑

X

X

X

Administering Oxygen    Ω   **   ∑

X

X

X

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Assessment for Hypothermia  **

X

X

X

X

X

X

X

X

Treatment of Mild or Moderate Hypothermia 

X

X

X

X

X

X

X

X

Assessment for Heat Exhaustion vs. Heat Stroke

X

X

X

X

X

X

X

Treatment for Heat Exhaustion

X

X

X

X

X

X

X

X

Higher Level of Care Criteria: heat stroke, severe hypothermia, blisters 

Treatment of Heat Stroke     

X

X

X

X

Treating Severe Hypothermia or blisters  **

X

X

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Burn Assessment

X

X

X

X

X

X

X

X

Burn Dressings  

X

X

X

X

X

X

X

X

Higher Level of Care Criteria:  partial thickness, full thickness burns, > 10% TBS, circumferential, or burns on hands, feet, face, armpits, groin or airway

Burn Fluid Resuscitation (IV fluids)   Ω   **   ∑

X

X

X

Burn Pain Treatment (IV pain meds)  Ω   **   ∑

X

X

X

Severe Burn Dressings  Ω   **   ∑

X

X

X

X

Airway Compromise   Ω   **   ∑

X

X

X

X

Task/Skill

MP

RN

NAP

Paramedic

EMT

EMR/WFR

WFA

CERT

Sprain/Strain and Fracture Assessment   **   

X

X

X

X

X

X

X

X

Treatment (tape, wrap, brace, splint, chest seal)  **   

X

X

X

X

X